PREVALENCE OF ANTHROPOMETRIC AND CARDIOVASCULAR RISK FACTORS AMONG BULGARIAN UNIVERSITY STUDENTS
Abstract
The aim of this paper is to investigate the prevalence of cardiovascular risk factors and their conection with health risk anthropometrical factors on Bulgarian university students, the main in the South Bulgaria. The sample population of the study included total 386 young people, of which 303 females and 83 males, between 18-30 years of age i.e. the mean age is 21.3-21.4 years. They were from different regions of Bulgaria, mainly from Southern Bulgaria. The study was conducted transversally in the period between 2015 and 2017. For each person the weight, height, waist circumference and blood pressure were measured. On this base the body mass index and waist to height ratio were calculated by formulas. Underweight eas defined as BMI< 18.5, overweight as BMI 25-29.9 and obesity as BMI ≥ 30 kg/ m2. Waist-to-height ratio (WHtR) was used for evaluation of central /abdominal obesity, that was defined as WHtR ≥ 0.5. The prehypertension was defined when SBP >120 <139 and/or DBP ≥ 80 <89 mmHg and hypertension when SBP ≥ 140 and/or DBP ≥ 90 mmHg. The statistical processing of the data was done using software package STATISTICA 10.0 and SPSS 20.0 by means of descriptive statistics and multiple regression analysis. The results show that the underweight occurs among 1.2% of the men and among 15.2% of the women, the overweight occurs among 32.5% of men and 13.9% of women and obesity was found among 10.8% of the men and 8.6% of the women. Central obesity occur among 32% of males and 17% of females, independently of their nutritional status. The prehypertension occurs among 46% of the men and 28% of the women. The hypertension founds among 18% of the men and among 2% of the women. Among prehypertensive male students the overweight occurs among 35.7%, and obesity among 10.7% of participants, while among hypertensive male the overweight and obesity occurs in 18.2% and 36.4%, respectively. In group of prehypertensive females 22.4% are overweight and 14.9% are obese. Hypertension occurs among 20% of overweight and 40% of obese female students. In group of central obese male the prehypertension and hypertension occurs among 55% and 20%, respectively. Among central obese females 47.5% are prehypertensive and 7.5% are hypertensive. The results also show that the waist circumference has a serious potential to affect the blood pressure level at an early adulthood in both sexes. Conclusion: The higher prevalence of elevated blood pressure, overweight and central and abdominal obesity among Bulgarian university students maybe connect with factors such as a sex, hormonal status, hereditary burden and sexual differences in some lifestyle habits as a nutrition, smoking, alcohol consumption, physical activity, individual physiological and biochemical status, psychological stress during student life and other. The prevalence of this risk factors among young Bulgarian adults needs urgent attention and further evaluation because of the grave consequences of obesity and hypertension and because the hypertension and overweight is an important amendable risk factor in young life.
References
Al-Majed, H., Sadek, A. (2012). Pre-hypertension and hypertension in college students in Kuwait: a neglected issue. J Family Community Med, 19 (2):105-12. https://doi.org/10.4103/2230-8229.98296 PMid:22870414 PMCid:PMC3410173.
Amandeep, B., Kaur Brar, S., Kumar,R.(2009). Age specific relation of blood pressure with anthropometric variables among 19-24 years Punjabi female youth of Amritsar city in Punjab, India. Anthropologist, 11(3): 207-211.
Andreenko, E., Mladenova, S., Akabaliev, V. (2015). Anthropometric obesity indices in relation to age, educationa l level, occupation and physical activity in Bulgarian men. Nutricion Hospitalaria, 31(2):651-658.
Ashwell, M., Cole, T., Dixon, A. (1985). Obesity: new insight into the anthropometric classification of fat distribution shown by computed tomography. BMJ, 290: 1962-1964.
Aynaci, G., Akdemir, O. (2018). The Relationship Between Lifestyle, Health Promotion Lifestyle Profile II and High Blood Pressure In University Students. Open Access Maced J Med Sci, 6(9):1756-1761. https://doi.org/10.3889/oamjms.2018.314
Baig, M., Gazzaz, Z., Gari, M., Al-Attallah, H., Al-Jedaani, K., Mesawa, A. et al.(2015) Prevalence of obesity and hypertension among University students’ and their knowledge and attitude towards risk factors of Cardiovascular Disease (CVD) in Jeddah, Saudi Arabia. Pak J Med Sci ,31(4):816-820. doi: http://dx.doi.org/10.12669/pjms.314.7953
Birdanova, V., Penkov, A., Stoynovska, M., Petkov, K., Statev, N.(2013). Investigation Of Nutritonal Status Among Medical University Students By Antropometric Indices. Science Dietetics, 1-2, 27-32 (Article in Bulgarian).
Brandao, M., Pimentel, F., Silva, C., Cardoso, M. (2008). Risk factors for cardiovascular disease in a Portuguese university population. Rev Port Cardiol, 27(1):7-25.
Celermajer, D., Sorensen, K., Spiegelhalter, D., et al.(1994). Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol, 24:471-476.
Cheah, W., Helmy, H., Chia, H., et al.(2018). Hypertension and its association with anthropometric indexes among pre-university students. Int J Adolesc Med Health. Malays Fam Physician, 13 (1): 2-9.
Chobanian, A., Bakris, G., Black, H., Cushman, W., Green, L., et al. (2003). The seventh report of the Joint National Committee on detection, evaluation and treatment of high blood pressure: the JNC 7 report. JAMA, 3; 289:2560-72.
Crnobrnja, V., Srdić, B., Stokić, E., Dujmović, F., Andrejić, B.(2012). Analysis of obesity prevalence in students from Novi Sad. Med Pregl. 65 (3-4):133-7. (Article in Serbian).
Dalton, M., Cameron, A., Zimmet, P., Shaw, J., Jolley, D., Dunstan, D., Welbom, T.(2003). Waist circumference, waist hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intem Med, 254: 555- 563.
Daud, S., Javaid, F. (2012). Estimation of Body Mass Index (BMI) in medical students. –PJMHS, 1, 5: 702–705.
Dyakova, M., Shipkovenska, E., Dyakov, P., Dimitrov, P., Torbova, S.(2008) Cardiovascular Risk Assessment of Bulgarian Urban Population: Crosssectional Study. Croat Med J, 49:783-91.
Emmons, K. (2000). Behavioral and social sciences contributions to the health of adults in the United States. – In: Smedley, B., S. Syme (Eds.). Promoting health: intervention strategies from social and behavioral research. (pp.254–321).Washington, DC, Institute of Medicine, National Academy Press.
Farrag , A., Eraky, A., Aroussy, W., Sayed, G., Mahrous, A. et al. (2015). Obesity and Other Cardiovascular Risk Factors in Egyptian University Students: Magniude of the Problem. Epidemiology (sunnyvale) 5: 181, doi:10.4172/2161-1165.1000181.
Feliciano-Alfonso, J., Mendivil, C., Ariza, I., Perez, C. (2010). Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia. Rev Assoc Med Bras. 56(3): 293-298.
Furukawa, Y., Ehara, N., Taniguchi, R., Haruna, Y., Ozasa, N., Saito, N., Doi, T. et al.(2009). Coronary risk factor profile and prognostic factors for young Japanese patients undergoing coronary revascularization. Circ J, 73(8):1459-1465.
Gharaibeh, M., Alzoubib, K., Khaboura, O., Tinawia, L., Hamada, R., Keewanc, E., Matarnehb, S., Alomarid, M.(2012). Assessment of Cardiovascular Risk Factors Among University Students: The Gender Factor. Cardiol Res, 3(4):172-179.
Higgins, M., Kannel, W., Garrison, R., Pinsky, J., Stokes, J. (1988). Hazards of obesity-the Framingham expeience. Acta Med Scand Suppl, 723: 23-36.
Hsieh, S., Muto, T. (2005). The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women. Prev Med, 40: 216-20.
Jain, J., Mathur, H., Apte, S., Sinha, U., Agarwal, K., Chanchlani, R.(2014). Prevalence of Prehypertension and Hypertension and its Correlation with Anthropometric Measurements in Medical Students of Central India. Journal of Evolution of Medical and Dental Sciences, 3 (10): 2429-2433. doi: 10.14260/jemds/2014/2155.
Karen, K., Amy, S., Flora, H., et al. (2009). The contributions of weight problem perception, BMI, gender, mood, and smoking status to binge eating among college students. Eating Fehaviors, 10: 1–9.
Khan, N., Khoi, H. (2008). Double burden of malnutrition: the Vietnamese perspective. Asia Pac J Clin Nutr, 17 (1): 116-8.
Lee, S., Ryu, H. (2018). Relationship between dietary intakes and the double burden of malnutrition in adults of Malang, Indonesia: An exploratory study. Nutr Res Pract, 12(5):426-435. doi: 10.4162/nrp.2018.12.5.426. Epub 2018 Oct 1.
Lee, D., Cooper, R. (2009). Recommendations for global hypertension monitoring and prevention. Curr Hypertens Rep, 11:444–9.
Li, S., Chen, W., Srinivasan, S. (2003). Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA, 290: 2271-6.
Mackay, J., Mensah, G. (2004). World Health Organization. The Atlas of Heart Disease and Stroke. Geneva, WHO.
Martin, R., Saller, K. (1957). Lehrbuch der Anthropologie. Stuttgart: Gustav Fisher Verlag, 1- 661.
Michael, C., Thrasivoulos, T., Chryssa, P., et al.(2011). Evaluation of dietary habits and assessment of cardiovascular disease risk factors among Greek university students. – Appetite, 57: 377–383.
Mitova, Z. (2010). Relation between the nutritional status type and the arterial blood pressure in 9-15 -year-old schoolchildren from Sofia. Acta morphologica et anthropologica, 16: 76-87.
Mladenova, S., Andreenko, E. (2015). The prevalence of high-normal blood pressure and hypertension among 8 to 15-year old Bulgarian children and adolescents with various nutritional status (Smolyan region, 2012-2014). Anthropologist, 21 (1,2):51:60.
Paavola, M., Vartianinen, E., Haukala, A. (2004). Smoking, alcohol use, and physical activity: a 13-year longitudinal study ranging from adolescence into adulthood. J Adolesc Health, 35: 238-44.
Petrova, S., Duleva, V., Rangelova , L.(2012). Monitoring on nutritional status of Bulgarian population: prevalence and trends of obesity and underweight. Science Dietetics, 2: 18-29 (Article in Bulgarian).
Physical status: the use and interpretation of anthropometry (1995). Report of a WHO Expert Committee. World Health Organ Tech Rep Ser, 854:1-452.
Ribeiro, R., Coutinho, M., Bramorski, M. (2010). Association of the Waist-to- height ratio with cardiovascular risk factors in children and adolescents: The three cities heart study. Int J Prev Med, 1(1): 39-49.
Rogacheva, A., Laatikainen, T., Tossavainen, K., Vlasoff, T., Panteleev, V., Vartiainen, E.(2006). Changes in cardiovascular risk factors among adolescents from 1995 to 2004 in the republic of Karelia, Russia. Eur J Pub Health, 17(3): 257-62.
Sakurai, M ., Miura, K., Takamura, T., Ota, T., Ishizaki, M., Morikawa, Y., Kido, T., Naruse, Y., Nakagawa, H. (2006). Gender differences in the association between anthropometric indices of obesity and blood pressure in Japanese. Hypertens Res., 29 (2):75-80.
Skovlund, A., Hasle, N., Toftegaard Pedersen, L., Peterson, B.(2011) . Female medical students are estimated to have a higher risk for developing eating disorders than male medical students. Dan Med Bul, 58: 1–5.
Stojanovic, D., Visnjic, A., Mitrovic, V., Stojanovic, M. (2009). Risk factors for the occurrence of cardiovascular system diseases in students. Vojnosanit Pregl.
Unal, A., Nazan, E., Osman, S. (2010). Eating habits, lifestyle factors, and body weight status among Turkish private educational institution students. Nutrition, 2010, 26: 772–8.
World Health Organization. Noncommunicable Diseases (NCD) Country Profile, 2015.
World Medical Association Declaration of Helsinki. (2000). Ethical principles for medical research involving human subjects. JAMA, 284(23): 3043-45.
Yusuf, S., Ounpuu, S., Dans, T. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 364: 937-52.